Our letter addressed the fact that their algorithm left out the plant-based diet, despite the fact that a plant-based diet lowers glycated hemoglobin more than the frontline drug, Metformin, and the American Diabetes Association diet combined. Unlike Metformin, the plant-based diet has no adverse reactions and no contraindications. It also can both treat and prevent common comorbidities such as diabetic peripheral neuropathy and coronary artery disease.

We thank the authors of the algorithm for their response. However, they completely side stepped addressing our central point: that a plant-based diet is a safe and efficacious treatment for Type II Diabetes and has many advantages over the leading medications. Instead, they appear to offer excuses. We are disappointed at their suggestion that the fact that many ethnic groups eat meat prevents the prescription of a plant-based diet. Their fear that their patients won’t accept this treatment is unfounded, considering studies that show even in rural Appalachia patients will accept it if prescribed by their doctors.

It’s never been easier to prescribe a plant-based diet to your patients, given that the largest supermarket chain in America, Krogers, supplies its stores with a wide variety of plant-based options such a veggie burgers and hot dogs, soy and almond milk and cheese alternatives. Plant-based products, once considered to occupy a small niche, have, in recent years grown considerably. For instance, Daiya, a cheese substitute, is sold at 25,000 different retail outlets in the United States. We suggest that doctors take note of what mainstream business already have.

We support the practice of evidence-based medicine. In this case, the evidence is quite strong. Good practitioners should act on the evidence and recommend the treatment of a plant-based diet to their Type II Diabetic patients.